RN Assistant Director, Utilization Review & Analytics

Nexus; Schertz (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Nexus is seeking an Assistant Director of Utilization Review to lead the Utilization Review Department onsite in Schertz, TX. You will supervise staff, analyze production data, and drive process improvements in medical necessity reviews across workers’ comp, group health, and disability programs.

The role requires a BSN with experience in Managed Care and strong leadership abilities. Proficiency with Word, Excel, and Outlook is essential, along with knowledge of state guideline-based reviews and

Qualifications

• BSN with 1–2 years’ experience in a Managed Care setting.
• Experience with state evidence-based medicine guidelines.
• Experience in a management role preferred.
• Proficient with Microsoft Word, Excel, and Outlook.

Responsibilities

• Provide leadership, supervision, training, and direction for the Utilization Review Department.
• Analyze data for individual performance evaluations of Utilization Review Nurses.
• Develop and monitor workflow processes and production goals using production metrics.
• Communicate regulatory updates to Utilization Review Nurses.
• Design and implement nursing retention and incentive strategies.
• Lead educational initiatives and case audits for nurses in training.

Skills

Leadership

Data analysis

Regulatory knowledge

Mentoring

Communication

Education

BSN

Tools

Microsoft Word

Microsoft Excel

Outlook

Job description

Nexus is seeking an Assistant Director of Utilization Review to lead the Utilization Review Department onsite in Schertz, TX. You will supervise staff, analyze production data, and drive process improvements in medical necessity reviews across workers’ comp, group health, and disability programs.

The role requires a BSN with experience in Managed Care and strong leadership abilities. Proficiency with Word, Excel, and Outlook is essential, along with knowledge of state guideline-based reviews and